The Internet: A practical example of the use of new technology in the assessment of vancomycin use in pediatrics

Background: The rapid emergence of both new infections and new technologies has revolutionized health care during the past 50 years. Increased use of the Internet has enabled health care professionals to educate, interact, an d collaborate throughout the world in ways never before possible. Increased use of vancomycin has been associated with the emergence of organisms with decreased susceptibility to vancomycin, such as Enterococcus and staphyloc occal species. The purpose of this article is to describe our experience us ing Internet technology to assess vancomycin use at children's hospitals in the United States. Methods: A Web-based evaluation was developed and distributed on the Intern et to 57 Pediatric Prevention Network hospitals. The evaluation was structu red to collect summary statistics on vancomycin use and admissions data by service for 1997 and 1998. Results: Twenty-four hospitals were able to provide archived vancomycin use and patient admissions data; completed evaluations were returned from 15 h ospitals (62.5% response rate). Personnel at 6 (40%) hospitals completed th e evaluation directly on the Internet. Conclusions: In our study, Internet technology facilitated a more efficient evaluation of vancomycin use, but fewer than half of the personnel at Pedi atric Prevention Network hospitals completed the evaluation directly on the Internet. It is unclear whether personnel at these hospitals were limited in Internet access, support, or understanding. Efforts should be directed t o educate health care personnel on the advantages of the Internet. Furtherm ore, many of the pharmacy databases used in our assessment were not standar dized across hospitals nor systematically validated. Understanding that lim itations still remain-within the source of the data studied, the health car e system sampled, and the Internet tools available-is essential because the Internet offers health care professionals today a tool both to protect pat ients and to improve quality throughout the world.